For any questions about these preps, please contact the Radiology Nursing office at

802-847-3946

What is a Needle biopsy?

A needle biopsy is a medical test that has been ordered by one of your doctors that can identify the cause of an abnormal lump or mass in your body. A radiologist performs this procedure in the radiology department. During the procedure, the radiologist inserts a small needle into the abnormal area and removes a sample of the tissue, which is given to a pathologist, who looks at it under a microscope. The pathologist can determine what the abnormal tissue is; cancer, non-cancerous, infection or scar.

Why do I need a needle biopsy?

The most common reason to need a needle biopsy is to identify the cause of an abnormal lump somewhere deep in your body. Imaging tests such as ultrasound, CAT scan , and magnetic resonance (MRI), can find abnormal masses, but these tests alone cannot always tell your doctor what the lump or make of the tissue is. A needle biopsy can determine the cause of an abnormal lump or mass. Your doctors need this information in order to provide you with the best care and treatment.

What are the risks to having a needle biopsy?

Some of the risks depend on which area or organ is undergoing the biopsy. With any needle biopsy there are common risks.

INFECTION: Any time the skin barrier is broken there is a risk of infection. All biopsies are done with sterile technique. The radiologist cleanses the skin with betadine and uses sterile towels and drapes. 

BLEEDING: This is why we have you get your blood drawn two weeks before the biopsy to make sure your blood work is within normal limits. We also ask your doctor that is requesting the biopsy to tell you NOT to take blood thinning medicines such as coumadin, aspirin, motrin, ibuprofen or other NSAIDS. NSAIDS are medicines often taken for arthritis or autoimmune diseases. The x-ray machine helps the doctor see where big arteries and veins are so they can avoid them.

INJURY TO ORGANS NEARBY: Again, this is why we do these biopsies in radiology. The x-ray machines guide the radiologist to see what she/he needs to avoid.

FAILURE TO GET ENOUGH TISSUE TO MAKE A DIAGNOSIS: This is why for FNA biopsies we have the pathologist present to look at each sample under the microscope. It is not uncommon to take anywhere from 2-8 samples. The pathologist will tell the radiologist when they feel they have enough cells to take to the lab to apply the different stains and dyes to make a diagnosis.

AIR LEAK/COLLAPSED LUNG OR PNEUMOTHORAX: (For chest or lung biopsies only) Air leaks through the small needle puncture hole from the lung into the space between the lung and inner chest wall called the pleural space. This would require close observation and serial chest x-rays to assess the size of the leak. A small pneumothorax may resolve on its own. A large pneumothorax may compromise your breathing and require that we place a small drainage tube called a chest tube to re-expand your lung. You would need to spend the night in the hospital and be sent home the next day once your chest x-ray shows your lung is fully re-expanded.

How do I prepare for my needle biopsy?

You will have diet restrictions prior to the procedure, usually no solid foods 6 hours before the appointment and clear liquids( water, black tea/coffee, apple, cranberry,grapefruit, grape juice, jello or broth) only two hours before the appointment.

If you take blood thinners such as coumadin you doctors needs to tell you its OK to stop this for 1 week before this procedure.

You will be asked not to take Aspirin, Motrin, Ibuprofen, NSAIDS for at least 7 days.

NSAIDS are often medicines taken for arthritis or an autoimmune disease.

Some of these medicines interfere with your bloods ability to stop bleeding.

If you have continued to take these medicines we will need to reschedule your appointment.

We also need to have your blood levels drawn within two weeks of your appointment. We will not be able to draw your blood on the day of your appointment; we need the results before we start. The levels we need drawn are P.T., I.N.R. and a hemagram.

If you do not have orders for blood work please call your doctor to have them order the above laboratory tests.

In most cases, you will be an outpatient when you have a needle biopsy. You will come to the radiology department 1 hour before your appointment time and you will return home after the recovery phase of the procedure. Wear comfortable clothing. You may want to bring reading material with you.

What is a needle biopsy procedure like? Will it hurt?

First the nurse or technologist will start an IV line for IV fluids and medications to be administered.

From feedback that we get from our patients, the hardest part of the biopsies in CAT scan is the positioning. You will need to have your arms above your head and may be on your stomach, back or one of your sides. We work hard at trying to get you as comfortable as we can using pillows etc. The positioning is critical, if you move, the measurements the doctor has taken to determine distance in millimeters, will change and we will have to start over each time. 

Then, the radiologist will use some form of imaging( Ultrasound, or CAT Scan ) to determine the best site on your skin for the needle to be placed for the biopsy. Next the radiologist will wash the area where the needle biopsy is going to be performed and put local anesthetic in the skin and deeper tissue to numb the area. The radiologist will then put a small needle into the mass or lump. This doctor will take CT, ultrasound images of the biopsy area during the procedure. These internal pictures will help the radiologist put the needle exactly in the right place. You usually feel some pressure during the procedure. The radiologist will use the biopsy needle to remove a tiny piece of tissue or cells from the lump or mass. The pathologist will be present during the procedure to view the sample to help assure that we have an adequate sample for them to analyze.

There are two types of needle biopsies FNA (fine needle aspiration) a long thin needle or a Core biopsy needle( a larger needle that takes a sample that looks like a small piece of angel hair pasta) Pathologist may not need to be present, the sample is sent to the laboratory. A needle biopsy usually takes 1-2 hours.

What happens after the biopsy? Can I go home?

After your biopsy you will be asked to stay in the hospital to recover for a set time period so that a nurse can watch you to make sure you are all right. Most people go home between one and four hours after their biopsy. You can eat and drink once you arrive to your recover area. You will be given an instructions sheet explaining the do's and don't and what to look for following your biopsy.

Take it easy for the rest of the day after your biopsy. You may be sore in the biopsy area for one to two days. A radiology nurse will call you the next working day to see how things went or you can call us at 802-847-3946

After the Procedure

The tissue (or cell) sample is sent to a doctor, call a pathologist who will examine the tissue or cells under a microscope. Usually, the results of the biopsy are ready in 2-3 days. It is best to ask your doctor for the results.